Observational studyAIDS and behavior2021
Association of Syndemic Unhealthy Alcohol Use, Smoking, and Depressive Symptoms on Incident Cardiovascular Disease among Veterans With and Without HIV-Infection.
Observational study in AIDS and behavior, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 18 citations in OpenAlex.
- A Randomized Feasibility/Acceptability Trial of Acceptance and Commitment Therapy for People with HIV Who Drink at Unhealthy Levels.AIDS and behavior · 2026Trial
- Major Depressive Episodes and Psychiatric Symptoms Among HIV Controllers Compared With Antiretroviral-Treated People Living With HIV.Open forum infectious diseases · 2026Article
- Prevalence and Associated Factors of Smoking Pattern Among Adult Women and Men in Nepal: Evidence From Demographic and Health Survey 2022.Public health challenges · 2026Article
- Syndemic Classes of Unhealthy Alcohol Use Reveal Inequities in Alcohol-Related Consequences and HIV Care Outcomes.Alcohol, clinical & experimental research · 2026Article
- Alcohol Use Disorder and Depression Among Community-Based Clinic Patients Before and During the COVID-19 Public Health Emergency, by Smoking Status.AJPM focus · 2026Article
- Health Benefits of Screening for Co-occurring Alcohol-, Substance-, and Mood-related Conditions for At-Risk Populations: A Mathematical Modeling Study.Journal of general internal medicine · 2026Article
- Acceptance and commitment therapy for people with HIV who drink at unhealthy levels: Protocol for the ACCEPT randomized controlled trial.Contemporary clinical trials · 2025Article
- Impact of syndemic heavy drinking, smoking, and depression on mortality among MSM with and without HIV: A longitudinal study.Drug and alcohol dependence · 2025Article
- Article
- Convergence between Cardiometabolic and Infectious Diseases in Adults from a Syndemic Perspective: A Scoping Review.Tropical medicine and infectious disease · 2024Article
- Cardiovascular Disease Risk Factor Control in People With and Without HIV.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Implications of vascular depression for successful cognitive aging in HIV Disease.Journal of neurovirology · 2024Article
- HIV and an Ageing Population-What Are the Medical, Psychosocial, and Palliative Care Challenges in Healthcare Provisions.Microorganisms · 2023Review
- Syndemic trajectories of heavy drinking, smoking, and depressive symptoms are associated with mortality in women living with HIV in the United States from 1994 to 2017.Drug and alcohol dependence · 2023Article
- The use of biomarkers to guide precision treatment for tobacco use.Addiction neuroscience · 2023Article
- Elevated frequency and everyday functioning implications of vascular depression in persons with HIV disease.Journal of psychiatric research · 2023Article
- Context, COVID-19 and comorbidities: exploring emergent directions in syndemics and HIV research.Current opinion in HIV and AIDS · 2022Review
Corrections and comments
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Authors and funding
20 authors at 13 institutions in 2 countries.
Funding
Abstract
Unhealthy alcohol use, smoking, and depressive symptoms are risk factors for cardiovascular disease (CVD). Little is known about their co-occurrence - termed a syndemic, defined as the synergistic effect of two or more conditions-on CVD risk in people with HIV (PWH). We used data from 5621 CVD-free participants (51% PWH) in the Veteran's Aging Cohort Study-8, a prospective, observational study of veterans followed from 2002 to 2014 to assess the association between this syndemic and incident CVD by HIV status. Diagnostic codes identified cases of CVD (acute myocardial infarction, stroke, heart failure, peripheral artery disease, and coronary revascularization). Validated measures of alcohol use, smoking, and depressive symptoms were used. Baseline number of syndemic conditions was categorized (0, 1, ≥ 2 conditions). Multivariable Cox Proportional Hazards regressions estimated risk of the syndemic (≥ 2 conditions) on incident CVD by HIV-status. There were 1149 cases of incident CVD (52% PWH) during the follow-up (median 10.1 years). Of the total sample, 64% met our syndemic definition. The syndemic was associated with greater risk for incident CVD among PWH (Hazard Ratio [HR] 1.87 [1.47-2.38], p < 0.001) and HIV-negative veterans (HR 1.70 [1.35-2.13], p < 0.001), compared to HIV-negative with zero conditions. Among those with the syndemic, CVD risk was not statistically significantly higher among PWH vs. HIV-negative (HR 1.10 [0.89, 1.37], p = .38). Given the high prevalence of this syndemic combined with excess risk of CVD, these findings support linked-screening and treatment efforts.
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